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Pezel T, Dreyfus J, Mouhat B, Thebaut C, Audureau E, Bernard A, Lavie Badie Y, Bohbot Y, Fard D, Biere L, Le Ven F, Fauvel C, Donal E, Mansencal N, Coisne A. Efficacy of simulation-based training on transoesophageal echocardiography learning in a multicentre randomised controlled trial: SIMULATOR study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Evidence on the impact of simulation-based training in transesophageal echocardiography (TEE) is scarce.
Purpose
We aimed to assess the efficacy of simulation-based versus traditional teaching on TEE knowledge and skills for cardiology residents.
Methods
Between November 2020 and November 2021, all consecutive cardiology residents inexperienced from TEE were randomised (1:1, n=324) through 42 French University Centers into two groups with or without simulation support (either a simulation group or a traditional group). The coprimary outcomes were the scores in the final theoretical and practical tests 3 months after the training. TEE duration and the feelings of residents were also assessed. An economic analysis was also performed.
Results
While the theoretical and practical test scores were similar between the two groups before the training (respectively P=0.80 and P=0.51), the residents in the simulation group displayed higher theoretical test and practical test scores after the training than those in the traditional group (respectively 47.2±15.6% vs. 38.3±19.8%, P<0.0001 and 74.5±17.7% vs. 59.0±25.1%, P<0.0001). Subgroups analyses showed that the efficacy of the simulation training was even greater when performed at the beginning of residency (P<0.0001). After the training, the duration to perform a complete TEE was significantly lower in the simulation group than in the traditional group (respectively 8.3±1.4 min vs. 9.4±1.2 min, P<0.0001). Finally, residents' feelings were better in the simulation group than in the traditional group across all components (P<0.0001). Compared to the traditional group, the average additional cost per resident of the simulation program was respectively €1,785, €942 or €662 for 20, 40 and 60 residents.
Conclusion
Simulation-based teaching on TEE showed a significant improvement in knowledge, skills, and feelings of cardiology residents as well as a reduction in the duration to complete the examination.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Pezel
- Hospital Lariboisiere , Paris , France
| | - J Dreyfus
- Centre Cardiologique du Nord (CCN) , Saint Denis , France
| | - B Mouhat
- University of Besançon , Besancon , France
| | - C Thebaut
- University Hospital of Limoges , Limoges , France
| | - E Audureau
- Henri-Mondor University Hospital, Unité de Recherche Clinique et Statistiques , Créteil , France
| | - A Bernard
- University of Tours - Faculty of Medicine , Tours , France
| | - Y Lavie Badie
- Toulouse Rangueil University Hospital (CHU) , Toulouse , France
| | - Y Bohbot
- University Hospital of Amiens , Amiens , France
| | - D Fard
- Henri-Mondor University Hospital, Unité de Recherche Clinique et Statistiques , Créteil , France
| | - L Biere
- University Hospital of Angers , Angers , France
| | - F Le Ven
- University Hospital of Brest , Brest , France
| | - C Fauvel
- University Hospital of Rouen , Rouen , France
| | - E Donal
- Hospital Pontchaillou of Rennes , Rennes , France
| | - N Mansencal
- Ambroise Pare Universitary Hospital, Cardiology , Paris , France
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Canitrot R, Delmas C, Delon C, Biendel C, Porte L, Bouisset F, Laperche C, Labaste F, Roncalli J, Elbaz M, Carrie D, Galinier M, Lavie Badie Y. Interpreting troponin elevation in the setting of infective endocarditis: Causes and prognostic value. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Desroche L, Safar B, Milleron O, Ou P, Garbarz E, Lavie Badie Y, Abtan J, Millischer D, Jondeau G. Magnetic resonance imaging as the first line imaging in left ventricular dysfunction: evaluation on 305 patients. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30151-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nallet O, Gouffran G, Lavie Badie Y. [Troponin elevation in the absence of acute coronary syndrome]. Ann Cardiol Angeiol (Paris) 2016; 65:340-345. [PMID: 27693169 DOI: 10.1016/j.ancard.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/02/2016] [Indexed: 11/15/2022]
Abstract
Cardiac troponins are the most sensitive and specific markers of myocardial injury. Cardiac troponin elevation are common in many diseases and do not necessarily indicate the presence of a thrombotic acute coronary syndrome. In clinical practice, interpretation of dynamic changes of troponin may be challenging. Troponin evaluation should be performed only if clinically indicated and must be interpreted in the context of clinical presentation, ECG changes, troponin level and kinetic. In the absence of thrombotic acute coronary syndrom, troponin retains a prognostic value. Its practical interest as a risk criteria is limited to a few situations like pulmonary embolism, pericarditis an myocarditis.
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Affiliation(s)
- O Nallet
- Service de cardiologie, centre hospitalier Le Raincy-Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France.
| | - G Gouffran
- Service de cardiologie, centre hospitalier Le Raincy-Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - Y Lavie Badie
- Service de cardiologie, centre hospitalier Le Raincy-Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
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